Posted
by
timothyon Tuesday June 26, 2012 @10:51AM
from the so-are-you-an-organ-donor? dept.

theodp writes "The Commercial Appeal reports that Dr. James Eason, the surgeon who performed Steve Jobs' liver transplant, found himself grilled at length Monday by Shelby County Commission members. The Univ. of Tennessee-Methodist Transplant Institute, which Eason heads, is in a bitter dispute over the distribution of human organs. Pressed for details by Commissioners West Bunker and Terry Roland about the 2009 liver transplant that Eason performed on the late Steve Jobs, Eason acknowledged that he's now living in the Memphis home that Jobs used during his convalescence. Bunker asked, "Was that a deal cut to get him a transplant here locally?" Eason: "I understand. It's a fair question. Absolutely not." Eason said a company lined up the housing for Jobs. "I took care of him and visited him in that home. And when I learned that it was going to be going on the market, I asked him, I asked the administrator of the LLC, if I could purchase it." So, is it time for Apple to shed some light on The Mystery of Steve Jobs' Memphis Mansion? It was reported that Apple lawyer George Riley, reportedly a friend of Eason's, helped Jobs with the arrangements for the Memphis mansion, which was acquired at a bargain price of $850,000 from the State of Tennessee by the mysterious LCHG, LLC on 3/26/2009. LCHG was formed on 3/17/2009, apparently just days before Jobs received his liver (on 3/21/2010, Jobs noted he was coming up on the 1-year anniversary of his transplant). Records show that title to the mansion was transferred to Eason in May, 2011, about three months after the National Enquirer painted a grim picture of Jobs' health. LCHG, LLC was dissolved in February 2012."

It means not only did Jobs buy his way to the head of the transplant line in a state he had never lived in, but his trust sold the house to the doctor who performed the transplant.
Legal, perhaps, but morally bankrupt. Jobs was a bad man.

Jobs was a known bad transplant risk (for cancer that had already spread to multiple organs, a common reason to take a person off the lists entirely), and that liver only bought him a couple of years, if that. There are plenty of people who gain 20 or 30 healthy productive years from a liver transplant - in fact the best estimate currently for how long a transplant patient will live if they make it through the first few months when organ rejection is likely is now averaging 30 years. So yes, Jobs got a lifetime like anyone else, but not all lifetimes are (re)created equal.

depends on whether or not he sold the home at market rates or reasonably close thereto.

Just because it's a mansion doesn't mean it's actually worth a lot. We just had a friend of the family die who owned a property with 3 buildings on it, where similar properties down the street were going in the 2-2.5 million range, the one in question got just under 500k. Because as it turns out, no one had updated the electrical system since the switchover from 25 to 60 Hz power, and 75 years of bats living in ceilings doesn't do buildings any favours. Who knew?

If you read the TFA's (and god are there a lot of them) the house was, pre 2008, appraised at between 1.3 and 1.4 million. And was the mansion for the university chancellor. Jobs bought it for 850k. Which, considering memphis has seen year over year price drops of easily double digits wouldn't be a huge shock. (http://www.trulia.com/home_prices/Tennessee/Memphis-heat_map/). Also keep in mind that the Steve jobs LLC probably paid cash.

From TFA, Eason paid 850K, which is the same as the LLC paid, I think.

So what I would read into this is that housing prices for Million plus dollar homes in memphis crashed by 40% from 2008 to 2009, or at least expensive house prices crashed, and then there was the specific house in question, which, having been a chancellors mansion for the university might have only a limited clientèle of people who would actually want it. (Location maybe? I've never been to TN let alone memphis so the address means nothing to me).

So sure, Steve probably got himself a deal from the government who were and are desperate for money on a house that wasn't going up in value any time soon. Whether or not it was actually an unfair deal is much harder to say. When housing prices are falling expect to get less than you were asking, and less than you appraised for.

I agree it wasn't right. That said, I hope you're never in such a desperate situation where you're dying and grabbing at anything to live. I wonder if you'd live up to your own high standards? I like to think I'd refuse to take advantage but having never been there I can't say. It's easy to Judge when you haven't been there.

It boils down to a question of is medicine a for profit industry or not. A major political question only in the USA. Regardless of what it "should" be, for profit or socialized, medicine clearly currently is a for-profit industry, here, at this time, so what he did obviously perfectly fits our moral code and obviously did not make him a bad man. He may have been immoral or bad in general or for other reasons, but merely participating in our healthcare system is not going to have an effect on his moral st

Wealth is direct proof of one's contributions and value to society. Poor people are poor because they can't do squat for their fellow man (that is worth paying for).

This would be true if we abolished inheritance and all children grew up in foster homes. How rich or poor you end up depends much more on how rich or poor your parents were than any other factor. And you didn't choose your parents, like mormons claim.

No. The issues is whether Steve arranged a kickback to the surgeon and his hospital in exchange for some preferential treatment. Did Jobs get a local (more convenient for him?) procedure, or did it go as far as being bumped up on the transplant list. If the latter, then it implies that Jobs used his money and position to get ahead of others who were also dying.

You begin to understand the problem, you just need to look a little bit further.

The system prioritizes those who could most benefit medically. That is, if you are likely to die even with the transplant, then you should be behind the person who might have a 80% chance of 20 or 30 more years of life with that same organ. If Jobs "greased the skids" to get himself to the head of the list even though he was likely to die with the transplant, then there are some serious questions to be answered.

Clearly the commissioners believe there is enough suspicion to investigate this more closely. It has the appearance of corruption on the part of the doctor and of Jobs.

There's a much bigger loophole that he exploited to get his transplant that's not even being discussed. Why are we even discussing Tennessee? Jobs lived in California. He was only on the list in Tennessee because he could afford to establish a residence in every state with a list that he wanted his name on and because he had access to a private jet to get him anywhere in the country on a moment's notice. The rest of us would be stuck waiting for a local organ to become available. If we want to ferret out corruption, why are we focusing on one doctor? Why not focus on the systematic flaws that allow the wealthy to get preferential treatment. A fairly simple law that would only allow someone to put their name on the list in only one state would make things more fair for everyone.

There are problems with the American system, but this isn't one of them. The organs have to be transplanted within hours of being harvested. Steve Jobs was willing and able to travel thousands of miles at the drop of a hat to get there in time. It's not reasonable or feasible to do that for everyone.

Prohibiting him from getting the organ equally makes no sense. It's based on need, so he was the one with the most need who could get there.

so it is fair that everyone should pay the same amount even if some people need more care?

Yes, so long as people don't actively do something that obviously and significantly negatively affects their health (like smoking, or, say, parkour). When they do, they should pay more if they require treatment as a consequence.

That article back then said, that, unlike most states in the U.S., Tennessee doesn't require a patient to be a resident of the state in order to be entered to the recipients' list.

It was required that when a trasplant organ was available and person X was on top of the list, this person should be at the TN transplant centre in 24 24 hours or even much less (don't remember the exact period of time that was stated). Otherwise (when nor showing up

Isn't that exactly how the American health care system works? I'm pretty goddamn sure that's what the republicans have been saying for years now. Those who can pay the most get the best treatment and fuck everyone else. That's it isn't it?

That's pretty much how the world works. You can bet rich people in the UK don't stand in line at the local clinic. Germany either. If you're a billionaire and you have a deadly disease what do you think you're going to do? I don't know about you but I'm going to come off the wallet and try to save my ass. It's reality.

And that is the way the world should work. People should be able to use money to buy things they want, encouraging more people to supply them. The problem here is that we have decided this shouldn't apply to organs, so the supply is severely restricted. If organs were treated like a normal commodity they would be far more plentiful because way more people would be donors. I have the donor dot on my drivers license, and was paid exactly $0 to volunteer.

Another problem is motorcycle helmet laws. By preventing lethal head injuries on otherwise young healthy individuals, we are removing a great source of organs. Maybe anyone who has volunteered to be a donor should be allowed to ride without a helmet.

By telling poor people: "tough luck, organs are awarded based on ability to pay and nothing else"?

"Sorry, 25 year old father of two, we know you were waiting on a heart transplant for that congenital defect that the hospital just discovered....but it went to Dick Cheney instead, cuz he's a rich bastard and you're not."

By telling poor people: "tough luck, organs are awarded based on ability to pay and nothing else"?

Why not? That is the way we distribute food, clothing and housing. Why should organs be different? What you are missing, is that if there were no artificial restrictions on organs, they would be far more plentiful. Most people don't check the donor box, because there is no incentive to do so. If they were prepaid $100, many more would do so.

By telling poor people: "tough luck, organs are awarded based on ability to pay and nothing else"?

Why not? That is the way we distribute food, clothing and housing. Why should organs be different? What you are missing, is that if there were no artificial restrictions on organs, they would be far more plentiful. Most people don't check the donor box, because there is no incentive to do so. If they were prepaid $100, many more would do so.

Because Capitalism should not be applied to EVERYTHING since Capitalism is not a cure all for all problems.

there is a benefit to being a donor -- they wont ruin you financially if your organs are good and you are braindead. they will declare you dead. seriously who wants to loose their house or other assets to a hospital when you can instead let your kin get those assets.

If you want to get that liver transplant, the surgeon isn't going ot do it for free.The hospital isn't going to provide your bed for free.

There is a huge shortage of donors.Direct selling of organs would lead to all sorts of abuses, and should never be allowed, but at the moment there are simply too few people who elect to be donors.If there was an annual amount paid to people with donor status on their licence, (which you could of course elect to drop from year to year) and that amount went up and down acc

Many people don't check the donor box because they are appalled at the greedy doctors, hospitals and pharmaceutical companies making good money off of their donated organs. Ever check the price of a transplant?

The difference is that many medical conditions leave people as poor and unable to "pay" the way you proclaim they should. Try fighting a life threatening disease for 10 years, see what it does to your bank account. Even rich people go broke from the medical industry.

How about a child that will die without a transplant? Can the child pay? Maybe their parents can but it's unlikely as they probably have 2nd and 3rd mortgages on their home, assuming they can even afford a home. How about the kids in foster care

As opposed to telling people at random, "Sorry, we know you were waiting on a heart transplant, but there are five people a month who will die without a heart transplant, but there are only two of the people a month who die actually signed up to be organ donors, even though there are ten a month whose hearts would be suitable for transplant."

Let's put it this way, if my organs aren't prioritized towards people who they'll help the most I'm opting out. In fact, I'd consider opting out of a system that only further increases costs and would never actually benefit me (that is, I'm dead one way and can't afford a transplant even the other).

I wouldn't be the one who's wrong then, as I don't claim that a financially motivated system would increase the pool. My heart doesn't matter if the pools bigger and you say it is. It's really simple, you want the system to be a financially regulated market, that's me voting by not selling my product to the highest bidder. If you are going to harvest my organs (which I don't have a problem with per se) then they go to the person with 20 y

Whoosh. I'm not talking about the cost of the operation, I'm talking about the "free market" setting the prices of organs before you even get to the hospital.

Poor people can be covered under Medicaid. What Medicaid wont do is get in a bidding war with a 71 year old former oil executive who can buy a donors heart for a cool $45 million and still have half his net worth [celebritynetworth.com] remaining.

And that is the way the world should work. People should be able to use money to buy things they want, encouraging more people to supply them. The problem here is that we have decided this shouldn't apply to organs, so the supply is severely restricted. If organs were treated like a normal commodity they would be far more plentiful because way more people would be donors.

The problem is that human organs are not a normal commidity. Money doesn't and shouldn't give you the right to someone's organs. Money doesn't make you more deserving of the right to live any more than money makes you more deserving of death. If you believe that if you are rich enough then you should be allowed to pay for the right to have, say, the organs that will be available once someone is taken off life support, you are not only putting pressure on a situation that already has deep ethical concern for the doctor and the patient's family, what you are in effect saying is that if you are rich enough, you should be allowed to pay to kill someone. To put it another way, if you believe it is ethical for you to be able to pay to have some available organ, then you must believe it is perfectly ethical that I can pay to prevent you from getting said available organ. Ultimately the argument for an organ market is an egocentric one, and it doesn't meet the criterial of universalization, meaning that what you wish is not applicable to all under similar circumstances, and it therefore cannot be ethical.

Yes they are. You only think they are not normal because they are scarce. But the scarcity is artificial. If you put a price on a commodity, more become available. Thousands of good organs go into graves and crematoriums everyday, because there is no incentive to do otherwise.

Every argument you give could be equally applied to food, which is even more important than organs. But we get famines [wikipedia.org] whenever we try to do the "moral" thing, and control food. Today we have an organ famine.

Lets say he and I needed liver transplants at the same time. I'm a nobody. I add very little to the world compared to Jobs. Why shouldn't he get bumped up in the priority list? Even better, why couldn't Steve and I bid for the liver with the proceeds going to the family of the donor? Losing a loved one must be difficult and expensive. Why not let the family profit.

Is there a better metric than money? Should it be good looks? Charitable donations? Nu

The Republicans are the party of the rich. They would never complain about rich people getting preferential treatment; when you're rich, it's expected. Any special treatment that Steve Jobs received was well earned because he was a self-made billionaire.

Yawn... no story here. Nothing other than vague insinuations without any substantiations. I suppose people like to get worked up over stuff like this to bring other people down a notch or two. At least in their simple minds.

When there is some real proof, let us know. 'Cuz I can see a different viewpoint...

Doctor: Nice place you have here Steve
Steve:Thanks
Doctor: If you ever decide to get rid of it, let me know. I might be interested in it.
Steve: You know doc, you've been real good to me. Tell you what, I'll sell it to you for a song to show my appreciation. It's a tough market out there now, and it would be nice to get rid of it.
Doctor: Wow.. what a great guy you are. Thanks

I find it interesting that people who always look for the bad in people always seem to find it. Must be a tough life, going around seeing the evil in every little thing while the beauty around you goes unnoticed.

Steve: You know doc, you've been real good to me. Tell you what, I'll sell it to you for a song to show my appreciation. It's a tough market out there now, and it would be nice to get rid of it.Doctor: Wow.. what a great guy you are. Thanks

Yeah... that doesn't really sound like something Steve Jobs would do though, Jobs was a smart guy, but he wasn't necessarily the nicest guy, he had an ego the size of everest and a sense of entitlement to match.

I read an article some time ago about this...don't recall where. Steve Jobs' health status was used as a springboard to discuss the issue.

From what I remember from the article, a person seeking a transplant can be on multiple transplant waiting lists across the US (it's broken up into regions). However, that person would have to be able to travel to any region where an organ became available very quickly once informed. Steve happened to have the means to do so. Not everyone does. If you're wealthy and healthy enough for such travel, you can apply to multiple waiting lists. The list in the Memphis/TN region tended to be shorter than others, thus he got an organ faster than in CA.

Travel after transplant surgery would likely be a big fat NO. He'd need time to recover and likely want to be near the surgeon and hospital where he got the surgery.

That doesn't speak to whether he got preferential treatment within the region, though. Hmmm...

Because we all know that Jobs would not have done a solid for a friend and sold it for a bargain price

Think about how many times just that sort of explanation has been used in court by people charged with racketeering, ponzi schemses, and similar. "Just a litte favor for a friend" is what people who are paying illegal kickbacks bribery, or extortion always say. A guy gets a contract for a new highway overpass, and it just haapens he recently built an outdoor hot tubbing area behind state representitive X's house at a bargain rate - just a favor for a long standing friend.

Here, a corporation was apparently formed and dissolved soon after just to handle this one transaction. Doesn't that sound like just maybe somebody knew they were guilty of something and was trying to cover it up? Oh no, people don't do that to hide from the law, they form new corporations just to do "a solid for a friend!".

"Determining whose need is most critical: The United Network for Organ Sharing uses measurements of clinical and laboratory problems to divide patients into groups that determine who is in most critical need of a liver transplant. In early 2002, UNOS enacted a major modification to the way in which people were assigned the need for a liver transplant. Previously, patients awaiting livers were ranked as status 1, 2A, 2B, and 3, according to the

The ideas of avoiding the appearance of impropriety and conflict of interest have gone right out the window. Just look at the Supreme Court and Congress. None of them obviously heard about it either.

Going through the motions of questioning a real estate deal like this seems rather quaint and rather cute, and it's sure to amount to nothing at all. When you are in the elite you can buy your way out.

Ok, so. It's a gossip piece, but it belongs on Slashdot's homepage because it involves Steve Jobs in a semi-tangential sort of way? Right, OK.

It is extremely common for people who happen to know another person to be cut a nice deal when selling property. In fact, I might even say that is normal. Jobs knew a guy, guy wanted to buy his house, Jobs sold it to him, end of story NO ONE GIVES A SHIT.

I'm not even sure what the summary is implying, and I really don't feel it is worth taking the time to find out. This isn't even "news", it's just sensationalistic crap (I'm assuming, I only skimmed the summary).

The implication is that Jobs found a doctor and said "Hey, want a nice house? How's about giving me a little bump up that transplant list, eh?" Corruption in medicine, playing with people's lives, and such. From TFS, it doesn't appear to be backed up by much more than some coincidental and very fortuitous timing, but it's a nice conspiracy theory.

Jobs certainly did seem to get his transplant rather quickly (although admittedly i'm more familiar with kidney transplants, where the wait can be up to seven years depending on where you live.) But i'm sure there are numerous ways to shorten the wait if you happen to be incredibly rich, most of them easier and more circumspect than bribing your doctor with cheap real estate.

But, correct me if I'm wrong, there is zero evidence that happened, correct? Only innuendo and "questions"?

Maybe it's also time for Apple to answer the question of whether or not Steve Jobs liked to rape chickens? I'm not saying he did, mind you, I just think the question should be asked.*

*Note: I'm not actually asking the question, because it's stupid. Just like this story. The only point in "asking" a question like this, without actual evidence, is to incite outrage. Nothing more. I'm sure someone on the

Well the thing is, this isn't about jobs. I fully expect someone with as much money as him to want to do whatever is in his power to get himself a replacement liver....even breaking the law. I dunno about you, but I put my own health above the law and if some law was standing in the way of what I saw as something that would allow me to live longer or live normally longer, guess what, I would probably do it too.

Thats why, the rules are not for the patients, they are for the doctors, the people who make the d

I dunno about you, but I put my own health above the law and if some law was standing in the way of what I saw as something that would allow me to live longer or live normally longer, guess what, I would probably do it too.

The law is largely irrelevant, but I put honour above my health. I wouldn't be able to live with myself if I received a transplant that someone else needed more.

Here's a clue for those who don't understand how LLCs work or why people use them: This kind of thing is done every. single. day. Rich people form LLCs and trusts to move and shelter assets and to avoid taxes. Not-so-rich people do it, too, because it's a good vehicle for keeping business costs outside personal finances. Something almost exactly like this happens all the time with everyone from the small profitable restaurant owner up through corporate middle mana

This is the type of stuff that always happens when there is a prohibition on something. It makes the gatekeepers so powerful that people will use whatever means necessary to influence them.

Acknowledging that people own their bodies would allow them to sell parts of their bodies. Those that can be harvested while they are alive like bone marrow, kidneys, parts of the liver, would be pretty straight forward. Those that are harvested after death might involve getting a deal on life insurance if you transfer ownership of your organs to the insurance company after death, or you could will them to a family member.

This would make organs so readily available that no black market would exist.

Except that allowing a market in organs would make the suspected problem here the norm. But much worse things would happen - witness the lack of respect for life amongst the Mexican drug cartels and their ilk, and imagine what would happen if they could get tens of thousands of dollars for a person's organs.

There are a few reasons for a market prohibition. The first and foremost is that it coerces the poor. Imagine someone in extreme poverty: he'll no doubt sell one of his kidneys (IIRC, it's the most required organ), permanently impairing himself.

A more reasonable way is to make organ donation compulsory after death and/or live transplants only from family members older than, say, 35.

Which is exactly what you appear to be against - only now it would be open and above board.

Honest and less corrupt. Rather than paying off a doc and/or administrators, you'd be paying off the donor's family. Honest in that instead of ridiculous claims of treating everyone equally, they'd honestly explain its ranked by $ which is how its always been done anyway and probably always will be done.

The problem with this scheme is I see is much like life insurance related murders, you'd now have organ donation murders. Or "I hate my kids so I'll drink heavily to make sure they make no money off my li

Not at all. Right now the donor gets zero compensation so there is a very limited supply. This pushes the value up which makes the people in charge of distribution very powerful. This power attracts corruption by those with the means to do it.

A market is the exact opposite. By allowing compensation to the donor there will be a vastly larger supply of organs. This will push prices down and make them more available.

Even if this wasn't the case I would still be for it because to reject the argument means that

Nope. Right now there are price controls on the supply of organs. The price is zero. How do you think that is effecting supply? If you allow people to get paid for their own body the supply will increase dramatically. This increase in supply will allow more people to get organs. Sure the rich will be able to buy their way to the front of the line but that is true with everything. The rich have much better and safer cars, houses, ect than other people. But this also helps innovation by allowing the developme

While on the outside the situation has the appearance that there could have been impropriety, the appropriate thing of course is to look at the hard evidence.

Giving a sweet deal on real estate to a friend and doctor for excellent medical care is not illegal. (While I haven't received a house, I get homemade baked goods all the time.) Giving a sweet deal on real estate to a friend as a kickback for being pushed up the transplant list is highly unethical. But there's an easy way to find out: have the state medical review board take a peek at the transplant waiting list records over the time period. If Steve Jobs mysteriously moves up the list for no good medical reason, or is listed in front of other patients with more pressing need or waiting time, then you have your smoking gun. Otherwise, if everything is appropriate with the transplant waiting list, then it sounds like the system worked as designed.

Let the litany of Jobs worshippers now feast upon all my +1 funnies with -1 overrateds. I suppose had I made a joke about how Apple's iDied product isn't selling so well, or another iSomething joke, it'd be -1000 flamebait and they'd have to call Malda out of retirement to help rewrite the code so it'd be more resistant to having everyone on the internet simultaniously facepalm, lol, and then -1 a single comment. *maniacal laugh* Soon my pretties...

Yep... for someone like Steve Jobs, a 1 million dollar 6000 square feet home is basically a tiny shack - like his own private hospital room. It's quite obvious they got it purely to cheat the transplant system. The doctor needs to be held accountable, his actions were negligent at best and quite possibly criminal. Giving a liver to someone who has almost no chance of surviving while other younger healthier people are dying because they didn't get the liver they need. This is not good. There needs to be an i

It is of course fairly obvious the home was only purchased to game the transplant waiting list system in place in the U.S. That he was placed ahead on the list in that state by the doctor in question is pure conjecture, though.

Not everyone can receive every organ that comes up for being transplanted. AFAIK, you need a fairly complex match of genetic compatibility for an organ to be actually useable for a given patient - and even in case of a "match", you need to keep taking fairly heavy immunosupressants during the rest of your life to keep your body from rejecting it. And since I would assume that there is a separate list for each (for lack of a better word - IANAMD) genetic category that donor organs come in: maybe SJ was indeed the front of the waiting list for the liver he ended up with? Without access to the relevant medical records that question is absolutely impossible to answer.

What does surprise me is that he got a transplant at all in the first place. In Europe, advanced stage cancer patients usually are not eligible to receive any transplants whatsoever, due to the general scarcity of donor organs, and the low expected benefits of transplantation in such a patient. This seems to be different in the U.S., though, otherwise someone else would already have commented on that?

It is of course fairly obvious the home was only purchased to game the transplant waiting list system in place in the U.S.

Why would you conclude that? He doesn't have to own a residence in the area to be on their list. He could have just as easily stayed at a rental property, or anywhere else that would allow him to reside there temporarily - heck, if he had a friend in Memphis, he could have easily just stayed at their place if they were willing to put him up.

The issue would be if, for example, Steve jobs secret LLC bought the house for 1.3 million and then re-sold it to the doctor who performed his surgery for 850k and that was significantly different from market rates.

From the looks of it they bought and sold for 850k on a property appraised before the 2008 crash at 1.3-1.4 mill.